Fri Aug 09 2024

27 articles - From Friday Aug 02 2024 to Friday Aug 09 2024

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…


Meta-analysis

meta-analyses and systematic reviews

Am J Clin Nutr

Impact of the ketogenic diet as a dietary approach on cardiovascular disease risk factors: a meta-analysis of randomized clinical trials.

Although the ketogenic diet demonstrates benefits in terms of triglyceride, blood pressure, weight, and glycemic control, its impact on CVD risk factors, especially the elevated total cholesterol and low-density lipoprotein cholesterol concentrations, warrants a cautious approach.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Am J Clin Nutr

Cause-specific and all-cause mortalities in vegetarian compared to non-vegetarian participants from the Adventist Health Study-2 cohort.

Vegetarian diets are associated with lower risk for all-cause and many cause-specific mortalities, especially among males and in younger subjects. However, higher risks were observed among older vegetarians for stroke and dementia. These results need further support and investigation.

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Intergenerational transmission of sucralose and acesulfame-potassium from mothers to their infants via human milk: a pharmacokinetic study.

Ace-K rapidly transfers from human milk into infants' circulation whereas sucralose was detected at much lower concentrations and in some but not al infants. Future research should investigate effects of early life sucralose and ace-K exposure via human milk on infants' health.

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Navigating Complex Nutritional Challenges After Bariatric Surgery: Malnutrition, Multiple Nutrient Deficiencies, and Gastrointestinal Dysfunction in Pregnancy.

She was empirically treated for SIBO using systemic antibiotics and was started on parenteral nutrition to prevent further calorie deficit during pregnancy. This case underlines the complexity and challenges in diagnosing SIBO after bariatric surgery that includes creation of Roux-en-Y anatomy, including BPS/DS, and the relationship between albumin, malnutrition, and the effect of systemic inflammation on the latter two.

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Variation of LDL-cholesterol in response to the replacement of saturated with unsaturated fatty acids: a non-randomised, sequential dietary intervention study (RISSCI-1).

These findings support the efficacy of UK SFA dietary guidelines for the overall lowering of serum LDL-C, but showed marked variation in LDL-C response. Further identification of the determinants of this variation will facilitate targeting and increasing efficacy of these guidelines. Clinical trial registry The RISSCI-1 study was registered with ClinicalTrials.Gov (No. NCT03270527).

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Inflamm Bowel Dis

Assessing the Value of Histology and Anatomic Segment Evaluation Among Patients Undergoing Pouchoscopy.

In our evaluation, the added benefit of histology in the presence of visible endoscopic inflammation for disease activity assessment scores is unclear. The prognostic value of histologic inflammation without endoscopic inflammation warrants a longitudinal study.

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Comparative Safety and Effectiveness of Ustekinumab and Anti-TNF in Elderly Crohn's Disease Patients.

We observed comparable safety and effectiveness for ustekinumab and anti-TNF agents in treating elderly CD patients.

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Distribution of Serum Testosterone Concentrations in IBD Males and Associations With Inflammatory Bowel Disease Activity.

Lower testosterone concentrations in men with IBD may reflect confounding from other factors and are not independently associated with disease activity. Greater awareness and screening for sexual dysfunction should occur in males with IBD, particularly in those with a longer disease duration.

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Efficacy of Vaccination and Revaccination Against Hepatitis B Virus Using 2 Different Strategies in Patients With Inflammatory Bowel Disease.

IBD patients demonstrate lower response to HBV vaccination compared with the general population. Age, body mass index, type, disease activity, and immunosuppression negatively affect the response. Half of nonresponders may benefit from an enhanced revaccination attempt.

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Eosinophil Depletion as a Potential Therapeutic Strategy in Acute and Chronic Intestinal Inflammation Based on a Dextran Sulfate Sodium Colitis Model.

Eosinophil depletion prevents and decreases intestinal inflammation in a preclinical dextran sulfate sodium model without affecting fibrosis. These results pave the way for exploring eosinophil depletion as a novel treatment modality in addressing intestinal inflammation.

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Lifestyle Intervention Modulates the CD4+ T Cell Profile in the Blood of Crohn's Disease Patients.

The MBM program, whether guided or self-directed, has the potential to restore the CD4+ T cell profile of CD patients to levels comparable to healthy blood donors. Lifestyle interventions may benefit CD progression, symptoms, and immunological status, but further analysis is needed to substantiate these findings and to fully understand their clinical implications. (ClinicalTrials.gov NCT05182645).

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MYO5B and the Polygenic Landscape of Very Early-Onset Inflammatory Bowel Disease in an Ethnically Diverse Population.

Our results support the polygenic nature of VEO-IBD, in which key participants, like MYO5B, were identified through network analytics. Rare variant load within susceptibility genes may be relevant not only for the genetic origins of inflammatory bowel disease, but also for the age of disease onset. Our findings could guide future work in precision medicine.

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Mirikizumab Sustained Impact on Fatigue in Patients with Moderately to Severely Active Crohn's Disease in the Phase 2 AMAG Study.

Mirikizumab treatment significantly improved fatigue in patients with moderately to severely active CD, which was sustained to W104. The improvement in fatigue was correlated with improvement in clinical measures and was strongly correlated with improvement in QoL.

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One-year Safety and Effectiveness of Ustekinumab in Patients With Crohn's Disease: The K-STAR Study.

Ustekinumab was well-tolerated, effective, and safe as induction and maintenance therapy for CD in Korea.

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Resolving Resident Colonic Muscularis Macrophage Diversity and Plasticity During Colitis.

Our findings contribute to the understanding of the immune system in the muscularis propria niche during colitis by resolving the heterogeneity and origins of colitic MMφs.

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Unraveling Twisted Pouch Syndrome: A Narrative Review of Classification, Diagnosis, Treatment, and Prevention.

Pouches may rarely be inadvertently twisted during construction or twisted owing to adhesive disease or leaks. A high index of suspicion is needed to establish the diagnosis. We present a simple classification of twisted pouch syndrome that may aid in the prevention and recognition of these often difficult to diagnose postoperative complications.

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J Crohns Colitis

Fecal calprotectin diagnostic level gradient along the small bowel in patients with Crohn's disease.

FC may serve as a topographical biomarker of CD-activity, with its sensitivity to identify mucosal inflammation increases from proximal to distal SB segments.

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The costs of home monitoring by telemedicine versus standard care for inflammatory bowel diseases - a Danish register-based, five-year follow-up study.

Telemedicine is cost-effective for patients not receiving biologics. However, treatment with biologics is more expensive for patients enrolled in eCare. Careful attention to PRO in eCare improves quality of life and could prolong time to relapse.

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Liver Transpl

Quantile regression in the field of liver transplantation: A case study-based tutorial.

Our real-world cases demonstrate how quantile regression models give researchers a richer understanding of relationships in the data and provide more nuanced clinical understanding compared to more commonly used linear regression models. We encourage researchers to explore quantile regression as a tool to answer relevant clinical research questions and support their more widespread adoption.

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Pancreas

Combined EUS and ERCP in patients with malignant distal biliary obstruction is associated with reduced time to oncological therapy compared to ERCP and sampling alone.

In our cohort of patients, a combined approach was associated with improved diagnostic yield, reduced need for repeat sampling procedures and reduced time to evaluation and treatment, with similar therapeutic success and adverse event rates. Careful multidisciplinary discussion is recommended to avoid performing unnecessary EUS procedures on patients who will not benefit from further treatment.

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Preoperative chemotherapy with Gemcitabine for pancreatic cancer causes zinc deficiency.

The preoperative chemotherapy consistently reduced the serum zinc concentrations in the PC patients, regardless of their regimen such as GEM + S1 and GEM + nab-PTX. Monitoring the serum zinc concentration and appropriate zinc supplementation may be essential for PC patients undergoing preoperative chemotherapy and pancreatectomy.

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Risk factors of negative diagnosis of MRCP in acute biliary pancreatitis patients with choledocholithiasis.

The history of cholecystectomy, older age and male are independently associated with an increased risk of negative diagnosis of MRCP in ABP patients with choledocholithiasis. We suggest that patients with these risk factors should undergo EUS first, rather than MRCP.

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Pancreatology

Feasibility and efficacy of cell-free and concentrate ascites reinfusion therapy (CART) for advanced pancreatic cancer patients with massive malignant ascites.

CART is feasible and might be the optimal option to enable prolonged use of chemotherapy to improve the prognosis for late-stage pancreatic cancer patients.

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Incidence and risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE) in acute necrotizing pancreatitis (ANP) - A single center experience.

The overall incidence of VTE in our cohort of patients with ANP was 12.5 %, which was usually diagnosed within one month of hospitalization. High-risk patients can be stratified based on clinical and imaging characteristics and may benefit from intensive DVT screening and prophylaxis during hospitalization and following discharge.

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Recurrence pattern and its risk factors in patients with resected pancreatic ductal adenocarcinoma - A retrospective analysis of 272 patients.

The occurrence of recurrence and especially of early and metastatic recurrence are associated with a worse overall survival. Patients lacking preoperative diabetes, having high preoperative CA19-9 values and lymph node metastases are particularly at risk for (early) recurrence.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Pancreatology

Epigenetic regulation of the tumor microenvironment: A leading force driving pancreatic cancer.

The behavior of other cell populations in the tumor stroma such as cancer-associated fibroblasts, immune cells, and others are mostly regulated by epigenetic pathways. Here, we present an overview of the main cellular and acellular components of the pancreatic cancer tumor microenvironment and discuss how the epigenetic mechanisms operate at different levels in the stroma to establish a differential gene expression to regulate distinct cellular phenotypes contributing to pancreatic tumorigenesis.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…


Letters&Replies

Letters to the editors and authors’ replies

Pancreatology

Two cases of hemoptysis in pancreatitis and their rescue endovascular embolization.

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